Health tech helps create capacity on eve of Obamacare

Dayna Pearson of Scripps Health demonstrates MDLIVE, a new telemedicine platform rolled out to Scripps employees on Oct. 1. If the system proves efficient and effective, the system could be used with the public.
Alex Fuller

Dayna Pearson of Scripps Health demonstrates MDLIVE, a new telemedicine platform rolled out to Scripps employees on Oct. 1. If the system proves efficient and effective, the system could be used with the public.

On New Year’s Day, nearly 200,000 San Diego County residents will qualify for subsidized health insurance under the Affordable Care Act, and an additional 100,000 will be newly eligible for Medi-Cal coverage.

While it is not clear how many of those people will sign up right away, local health systems say they are turning to technology to help increase the capacity of their delivery systems when the wave of newly insured patients arrives.

From telemedicine systems that can allow patients to connect virtually with their doctors to wireless scales and asthma inhalers that can monitor chronic health conditions over the Internet, local providers are working to start, or expand, programs that work smarter with existing personnel.

The idea of using video cameras to communicate health information between doctor and patient has been around for decades, but, with the exception of scattered programs in far-flung rural areas, has never taken hold as a significant way that health care is delivered.

But that is rapidly changing, as a hyper-connected public becomes more comfortable with using video-enabled computers, smartphones and tablets in every aspect of daily life.

On Oct. 1, Scripps Health launched a program that allows employees to use MDLIVE, a telemedicine service based in Sunrise, Fla., that provides a doctor on demand to diagnose nonemergency medical problems via video conference, email or telephone.

Dr. Anil Keswani, Scripps vice president of ambulatory care and population health management, said the program is intended to provide a quick consult for common health problems, such as a sore throat or persistent cough.

“It’s not meant for chest pain or shortness of breath or the other things that the emergency department is there for,” Keswani said.

He said the health system will monitor how its own employees use MDLIVE before deciding whether to roll the system out to the public.

“If we can measure some positive outcomes, and we really bend the cost of care, then I think we really have a chance to roll this out in a larger way,” Keswani said.

Kaiser Permanente has been one of the largest users of telemedicine for years.

Bernstein, the Kaiser medical director, said a “Telederm” program provided 15,000 skin cancer consultations in the region last year. The system uses high-resolution cameras in family medicine offices to transmit still photographs of potentially cancerous skin lesions to dermatologists for review.

The system he said, is also in trials on using video conferencing for lactation and pre-surgery consulting, where, in some cases, a face-to-face visit is not required.

Kaiser is also considering kiosks that could be placed in high-traffic areas where a patient could step inside and be immediately connected with a doctor who could perform a basic diagnosis, including blood pressure screening, remotely, he said.